2803 COLBY AVE YUMMY BANH MI 2019-11-01

E :CTRICAL PERMIT APPLY "TION CITY OF EVERETT PERMIT SERVICE: /11100,/SC-1 *4dV3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2803 Colby Ave BUILDING AREA: sq ft PROJECT TYPE: NEW CONSTRUCTION ❑ ADDITION ✓ TENANT IMPROVMENT REMODEL BUILDING USE: C SFR C TOWNHOUSE ❑ DUPLEX ADU ❑ MULTI-FAMILY-#OF UNITS: Iv l COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 5,494 ASSOCIATED BUILDING PERMIT#(if applicable): S1812-001 DESCRIBE SCOPE OF WORK: Hook up electrical sign on front of building facade to existing sign circuit. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? NO n YES-Select Scope: Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ✓❑ NO 7 YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat ❑ Audio LI Secure Access Cl Security System ❑ Fire Alarm- Installations under this permit only include electrical wiring rough-in of the system.An additional Fire Alarm Permit is required for review of device location and installation approval. ✓ Other(List All):Channel Letter Signs on raceways CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ❑✓ NO ❑ YES--See Below&Pg. 2 By checking this box, I am stating that I have read and understand all of WAC 296-46B-900,selected the specific reason on page 2 of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not See Page 2 require Plan Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: El NO DYES-See Below&Pg. 3 Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent, sale, or lease without the proper electrical licensing and certification, or exemption. By checking this box, I am stating that I have completed and See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME: SKOTDAL FAMILY INVESTMEIj TENANT BUSINESS NAME(If Commercial): YUMMY BANH MI OWNER MAILING ADDRESS: STREET 2707 COLBY AVE STE 1200 CITY EVERETT STATE WA ZIP 98201 OWNER PHONE:425 252 5400 OWNER EMAIL:' PAVE. GR A E F @ $ T-D A L, CONTRACTOR NAME: SpencFab CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE:206-468-3999 CONTRACTOR EMAIL:ussigntony@gmail.com CONTRACTOR LIC.#(REQUIRED):SPENCSM903L9 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: OWNER CONTRACTOR OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:Cell: 206-468-3999 Tony Le CONTACT EMAIL:ussigntony@gmail.com AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: Z7G 2-1-2019 F O Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application